Peds - Safe Med Dose Administration
A nurse provides medication instructions to a first-time mother. Which statement made by the mother indicates a need for further instructions? A. "I should mix the medication in the baby food and give it when I feed the child" B. "I should administer the oral medication sitting in an upright position and with the head elevated" C. "I will give my child a toy after giving the medication" D. "I will offer my child a juice drink after swallowing the medication"
A. "I should mix the medication in the baby food and give it to my child" The nurse would teach the mother to avoid putting medications in foods because it may cause an unpleasant taste to the food, and the child may refuse to accept the same food in the future. Additionally the child may not consume the entire dosage. B. Administering the medication in an upright position and head elevated will prevent the risk of aspiration. C. Offering a toy will provide comfort measures to the child. D. The mother should offer drink such as juice or a soft drink to lessen the aftertaste of the medication.
A 4-month-old infant has just received diptheria, tetanus, and acellular pertussis (DtaP). Hours later, the mother report to the clinical because her child develops redness and swelling at the injection site. The nurse should instruct the mother to do which of the following? A. Application of cold compress B. Application of hot compress C. Monitor for signs of fever D. Report to the clinic for a repeat injection on the other side
A. Application of cold compress Redness, tenderness, and swelling may happen at the site of injection. This will be relieve through cool application for the first 24 hours, followed by warm compress if inflammation persists. B, C, and D are inappropriate interventions.
Hydrocortisone cream 1% is given to a child with eczema. The nurse gives instruction to the mother to apply the cream by? A. Apply a thin layer of cream and spread it into the area thoroughly B. Avoid cleansing the area before the application C. Apply a thick layer of the cream to affected areas only D. Apply the cream to other areas to avoid ocurrence
A. Apply a thin layer of cream and spread it into the area thoroughly Topical corticosteroids are administered sparingly and rubbed into the area thoroughly. B; the are should be cleansed first before administration C and D: Thick application and rubbing it on other areas will likely lead to systemic absorption.
A nurse is teaching a parent of an infant about administration of oral medications. Which of the following should the nurse include in the teaching? Select all that apply: A. Use a universal dropper for medication admistration B. Ask the pharmacy to add flavoring to the medication C. Add the medication to the formula bottle before feeding D. Use the nipple of the bottle to administer the medication E. Hold the infant in a semi-reclining position
B. CORRECT: Multiple flavorings are available to add to medications and can assist in masking the taste D. CORRECT: Administering medications through an empty nipple may assist with successful administration of the medication E. CORRECT: For successful medication administration, the infant should be held in a semi-reclining position, similar to feeding A. INCORRECT: Medication has different viscosities, and droppers do not have a standard opening. Therefore, a universal dropper is not an accurate way to measure medications C. INCORRECT: Because an infant may not finish an entire bottle of formula, it is not recommended to add medication to the bottle
A nurse is providing instructions to a mother who has a child with congestive heart failure (CHF) regarding Digoxin (Lanoxin). Which statemnt made by the mother indicates further teaching? A. "I will administer the medication 1 hour before or 2 hours after a meal" B. "I will use a special dose-measuring spoon or cup, not a regular tablespoon for the liquid preparation" C. "If my child vomits after administration, I will repeat the dose" D. "If more than one dose is missed, I will inform the physician"
C. "If my child vomits after administration, I will repeat the dose" Digoxin is a cardiac glycoside. The mother needs to be instructed not to repeat the dose once the child vomits it. A, B, and D are correct instructions regarding this medicine.
Which of the following is not true regarding varicella vaccine? A. It is administered subcutaneously B. Children 13 years and older (with no history of chickenpox or have not previously been vaccinated) need two doses given at least 28 days apart C. Give aspirin for any injection-related pain D. The most common mild side effects are pain, redness, or swelling at the injection site
C. Give aspirin for any injection-related pain Children receiving varicella vaccine should avoid aspirin or aspirin-containing products because of the risk of Reye's syndrome (a life-threatening metabolic disorder in young children, of uncertain cause but sometimes precipitated by aspirin and involving encephalitis and liver failure).
A nurse prepares to administer a 3mL injection via intramuscular injection to a 5-year-old child. The nurse selects which site to administer the medication? A. Rectus femoris B. Deltoid C. Ventrogluteal D. Vastus lateralis
C. Ventrogluteal IM injections are chosen based on the child's age and mucle development. The ventrogluteal muscle is the ideal choice to administer 0.5mL-3mL amount of injection on a 3-12-year-old child. A. Rectus femoris and D. Vastus lateralis only allows for 2mL amount of injection. B. Deltoid allows 0.5-1mL amount of injection.
A nurse is monitoring the intake and output of an infant receiving furosemide (Lasix) IV. Which of the following method is the most appropriate in measuring the urine output? A. Ask the mother regarding the number of diaper changes B. Compare intake with output C. Weighing the diaper D. Insert foley catheter
C. Weighing the diaper The most appropriate method for measuring urine output of an infant is by weighing the diaper. A and B will not provide accurate measures of urine output. D: Inserting a foley catheter will provide the most accurate measurement but it gives the infant risk for urinary tract infection (UTI).
The nurse is giving instructions to a mother with a child receiving a liquid oral iron supplement. The nurse tells the mother to: A. Take it with meals B. Mix it with food C. Mix it with milk D. Administer it using a straw
D. Administer it using a straw An oral liquid iron supplement should be given with a straw because the medicine will stain the teeth. A: Taking it with meals will decrease the absorption B and C: Iron is not mixed with any food/drink.
A nurse is preparing to administer an intramuscular (IM) injection to a child. Which of the following muscle groups is contraindicated? A. Deltoid B. Ventrogluteal C. Vastus lateralis D. Dorsal gluteal
D. CORRECT: The dorsal gluteal site has major nerves and blood vessels and is not a recommended site for IM injections for children A. INCORRECT: The deltoid muscle can be used once developed for IM injections in children for medication containing up to 1mL of fluid. B. INCORRECT: The ventrogluteal muscle can be used for IM injections in children for medication containing up to 2mL of fluid C. INCORRECT: The vastus lateralis muscle can be used for IM injectios in children for medication containing up to 2 mL of fluid
A child was brought to the emergency department with complaints of nausea, vomiting, fruity-scented breath. The resident on duty diagnosed the child with diabetic ketoacidosis. Which of the following should the nurse expect to administer? A. Potassium chloride IV infusion B. Dextrose 5 IV infusion C. Ringer's Lactate D. Normal saline IV infusion
D. Normal saline 5% IV infusion The initial priority in the treatment of diabetic ketoacidosis is the restoration of extracelluar fluid volume through IV administration of normal saline (0.9% sodium chloride). A. Potassium chloride is not a part of the initial treatment B. D5W and C. RL are dextrose solutions and will be used only when the blood glucose level is decreased.
A 6-year-old is scheduled to have measles, mumps, and rubella (MMR) vaccine. Which of the following route will you expect the nurse to administer the vaccine? A. Intramuscularly (IM) in the vastus lateralis muscle B. IM in the deltoid muscle C. Subcutaneously (SubQ) in the gluteal area D. SubQ in the outer aspect of the upper arm
D. SubQ in the outer aspect of the upper arm MMR vaccine is administered subq in the outer aspect of the upper arm. A and B: MMR is not administered IM. C: Gluteal area is not used as a site.
A nurse prepare to administer an IM injection to a 6-month-old infant. The nurse selects which site to administer the medication? A. Rectus femoris B. Dorsal gluteal C. Ventrogluteal D. Vastus lateralis
D. Vastus lateralis IM injections are based on the child's age and muscle development. The vastus laterlis is the only muscle group to use for IM injection in a 6-month-old infant. A, B, and D are unsafe for that age.
A physician prescribes an IV solution of 500 mL 0.45% saline with an incorporation of 20 mEq potassium chloridefor a child with dehydration. The nurse should check which of the following before administratering this IV prescription? A. blood pressure B. height C. weight D. urine output
D. urine output When it comes to hypotonic dehydration, electrolyte loss exceeds water loss. The priorty assessment for the nurse is to check the urinary output before the administration. Potassium chloride is contraindicated for patients with oliguria (production of abnormally small amounts of urine) an anuria (failure of the kidneys to produce urine). A, B, and C are not related to the administration of this medication.
A nurse is handling a child who is on a Furosemide (Lasix) IV infusion. The nurse should instruct the mother to encourage the child to eat which of the following? A. Apricot and baked potato skins B. Bread and butter C. Gelatin and cauliflower D. Ginger ale and cereal
A. Apricot and baked potato skins One of the side effects of taking furosemide is hypokalemia (low blood potassium), so a supplemental food rich in potassium is encouraged. B, C, and D are low in potassium.
A nurse is caring for an infant who needs otic medication. Which of the following is an appropriate action for the nurse to take? A. Hold the infant in an upright position B. Pull the pinna downward and straight back C. Hyperextend the infant's neck D. Ensure that the medication is cool
B. CORRECT: Pulling the pinna downward and straight back will straighten the canal to allow medication to flow into the ear A. INCORRECT: Position the infant supine or prone for administration of otic medication C. INCORRECT: Hyperextending the infant's neck could occlude the airway ad shuld not be performed during otic medication administration D. INCORRECT: Allowing the otic medication to warm up to room temperature is recommended to provide atraumatic care
An unconscious child is brought to the emergency room due to Tylenol poisoning. Which of the following is the most appropriate nursing action? A. Administer mucomyst P.O. (by mouth) B. Gastric lavage with activated charcoal C. Gastric lavage with activated charcoal and mucomyst D. Administer ethylenediaminetetraacetic (EDTA)
B. Gastric lavage with activated charcoal In an unconscious child with Tylenol poisoning, the priority intervention is to administer gastric lavage with activated charcoal to decrease the absorption of Tylenol. A: risk for aspiration. C: activated charcoal inactivates mucomyst. D: this the drug choice for lead poisoning.
The nurse is reviewing the child's record who is scheduled to receive inactivated polio vaccine (IPV). Which of the following would prompt the nurse to withhold the administration? A. History (hx) of upper respiratory infections (URIs) B. Hx of anaphylactic reaction to streptomycin C. Hx of recent diarrheal episodes D. Hx of redness at the previous injection site
B. Hx of an anaphylactic reaction to streptomycin Inactivated polio vaccine (IPV) contains a trace amount of streptomycin, neomycin, and polymyxin A, C, and D are not contraindicated with this vaccine.
A nurse is preparing to administer medication to a toddler. Which of the following are appropriate actions for the nurse to take? Select all that apply: A. Identify the toddler by asking the parent B. Tell the parent to administer the medication C. Calculate the safe dosage D. Ask the toddler what toy he wants to hold during administration E. Offer juice after the medication
C. CORRECT: For safe medication administration, the nurse should calculate safe dosage prior to administering medication D. CORRECT: Offering choices to the toddler is an example of atraumatic care E. CORRECT: Offering juice after the medication is an example of atraumatic care A. INCORRECT: For safe medication administration, confirm two identifiers by looking at the idenification band or having the toddler state his name and date of birth B. INCORRECT: The nurse should assess the preferred level of involvement of the parents prior to medication adminitration
A nurse is planning to administer the influenza vaccination to a toddler. Which of the following is an appropriate action for the nurse to take? A. Administer subcutaneously in the abdomen B. Use a 20-gauge needle C. Divide the medication into two injections D. Place the child in the supine position
D. CORRECT: The vastus lateralis is recommended for administering IM medications. Therefore, placing the toddler in supine position is the appropriate action for the nurse to take A. INCORRECT: The influenza vaccination is administered IM B. INCORRECT: A 22- to 25-gauge needle is recommended for IM injections C. INCORRECT: The total volume if the influenza vaccination is 0.5mL, which can be administered in the vastus lateralis
A child with known hemophilia A was brought to the emergency room with complaints of nose bleeding and some bruising in the joints. Which of the following should the nurse anticipate to be given to the child? A. Oral iron supplement B. Cyclosporin C. Factor X D. Factor VIII
D. Factor VIII Hemophilia A, also called factor VIII (FVIII) deficiency or classic hemophilia, is a genetic disorder caused by missing or defective FVIII, a clotting protein. The inital treatment is the administration of factor VIII to replace the missing factor and decreases the bleeding episode. A, B, and C are not used in this case.
